| Entity Name: | WASKUCH THERAPY SERVICES, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 28 Mar 2014 (11 years ago) |
| Document Number: | P14000028645 |
| FEI/EIN Number | 46-5258285 |
| Address: | 1210 Buckhead Dr. SW, VERO BEACH, FL, 32968, US |
| Mail Address: | 1210 Buckhead Dr. SW, VERO BEACH, FL, 32968, US |
| ZIP code: | 32968 |
| County: | Indian River |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1568967032 | 2018-03-27 | 2023-02-09 | 1210 BUCKHEAD DR SW, VERO BEACH, FL, 329685088, US | 1210 BUCKHEAD DR SW, VERO BEACH, FL, 32968, US | |||||||||||||||||||||||||||||||||||||||||||||||
|
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| Phone | +1 321-536-3392 |
| Fax | 7726131917 |
Authorized person
| Name | JUDITH WASKUCH |
| Role | OTR/L |
| Phone | 3215363392 |
Taxonomy
| Taxonomy Code | 222Q00000X - Developmental Therapist |
| Is Primary | No |
| Taxonomy Code | 225100000X - Physical Therapist |
| Is Primary | No |
| Taxonomy Code | 225X00000X - Occupational Therapist |
| Is Primary | Yes |
| Taxonomy Code | 225XP0200X - Pediatric Occupational Therapist |
| License Number | OT13303 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 235Z00000X - Speech-Language Pathologist |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 100072500 |
| State | FL |
| Issuer | MEDICAID |
| Number | 000601800 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| WASKUCH JUDITH | Agent | 1210 Buckhead Dr. SW, VERO BEACH, FL, 32968 |
| Name | Role | Address |
|---|---|---|
| WASKUCH JUDITH | President | 1210 Buckhead Dr. SW, VERO BEACH, FL, 32968 |
| Name | Role | Address |
|---|---|---|
| WASKUCH JUDITH | Secretary | 1210 Buckhead Dr. SW, VERO BEACH, FL, 32968 |
| Name | Role | Address |
|---|---|---|
| WASKUCH JUDITH | Treasurer | 1210 Buckhead Dr. SW, VERO BEACH, FL, 32968 |
| Name | Role | Address |
|---|---|---|
| WASKUCH JUDITH | Director | 1210 Buckhead Dr. SW, VERO BEACH, FL, 32968 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2017-03-27 | 1210 Buckhead Dr. SW, VERO BEACH, FL 32968 | No data |
| CHANGE OF MAILING ADDRESS | 2017-03-27 | 1210 Buckhead Dr. SW, VERO BEACH, FL 32968 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2017-03-27 | 1210 Buckhead Dr. SW, VERO BEACH, FL 32968 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-20 |
| ANNUAL REPORT | 2023-02-24 |
| ANNUAL REPORT | 2022-01-31 |
| ANNUAL REPORT | 2021-02-18 |
| ANNUAL REPORT | 2020-01-15 |
| ANNUAL REPORT | 2019-03-08 |
| ANNUAL REPORT | 2018-03-14 |
| ANNUAL REPORT | 2017-03-27 |
| ANNUAL REPORT | 2016-03-02 |
| ANNUAL REPORT | 2015-04-09 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
